PAMPs and DAMPs: Culprits in the worsening of corneal ulcers?

  • Research type

    Research Study

  • Full title

    Pathogen and Damage Associated Molecular Pattern Molecules: Culprits in the worsening of corneal ulcers and ocular surface conditions?

  • IRAS ID

    141092

  • Contact name

    Umiya Agraval

  • Contact email

    umiya.agraval@nhs.net

  • Sponsor organisation

    NHS Greater Glasgow and Clyde

  • Clinicaltrials.gov Identifier

    14 / NE / 1077, NRES Committee North East - Sunderland

  • Research summary

    Bacterial corneal infections are common and one of the most important causes of corneal blindness worldwide. As the cornea is avascular, the defense mechanism and the sequel of corneal bacterial infection differ from that of vascular tissue. On initiating antibacterial therapy in the first 48 to 96 hours, one of the key features observed is worsening of inflammation and tissue destruction, despite appropriate antibiotic therapy.

    We believe there are two possible sources of this phenomenon. Bacterial endotoxins (molecules released from the cell wall of dying bacteria) can incite inflammation. However, there have been no studies that have explored the role of endotoxin in corneal ulcers. Secondly, there is also growing evidence of the role endogenous proteins, released as part of the infective and inflammatory process, play in inciting further inflammation. Such molecules are termed Damage Associated Molecular Patterns (DAMPs) and they have been shown to contribute to inflammation in both the eye and other systemically associated inflammatory diseases.

    In this study we will establish the role of bacterial endotoxins and DAMPs in ocular surface disorders by measuring their levels, in tandem with pro-inflammatory cytokines, in tears during the initial phase of treatment. If we can establish that endotoxins and DAMPs play a role in the worsening of tissue destruction, then we may be able to explore ways to neutralise this toxin.

  • REC name

    North East - Tyne & Wear South Research Ethics Committee

  • REC reference

    14/NE/1077

  • Date of REC Opinion

    17 Jul 2014

  • REC opinion

    Favourable Opinion